So it’s the day of the big speech, Mr. President, and we got trouble with a capital “T” right here in Health Care City.

What are you gonna do? Do we follow the traditional Democratic Party legislative process of passing…something…at any cost, assuming the entire time that the Left and the Netroots will “go along with the program”, or is there a risk that the calculus doesn’t work as well today as it did in 1994 and 1996?

Well, lucky for you, I’m a fake consultant, and I know a few things about your “target market”, so before you answer that question…we need to talk.

So the common sense approach to handling this situation is to make any deal required to get a bill passed, because otherwise your entire Presidency will be tagged as “strong on oratory but unable to govern”. Since the Far Left supports Democrats today and won’t be supporting the Republican Party under any circumstances, they’ll have no choice but to follow the “centrist” (read: “bluedog”) Democratic lead.

What you don’t want to do, common sense tells us, is demand that reform contain elements that simply are too tough to get through Congress. Insisting on a public option is absolutely out of the question, the new “preexisting conditions” requirements would be too onerous on the insurance companies—and requiring everyone to purchase insurance, with no public option competition at all to moderate the prices private insurers charge, and, for that matter, no guarantee of universal coverage, somehow makes perfect sense.

To mollify those who will object, we can hold out “triggers” as a compromise: in other words, Government says “hey, let’s wait a few years, and if the insurance companies still haven’t changed their ways…then we’ll do something.”

If you decide upon this approach, then the speech you want to give is to remind the Far Left and those pesky bloggers that political progress is incremental, you take what you can get, and that we can always come back later and make this whole stew of compromise better than what we propose to cook today.

While that’s a pretty good approach…most of the time…it won’t be this time.

There are two major reasons why, and, ironically, they’re both derived from your success in 2008.

Right off the bat, this strategy assumes the millions of new voters—and even more importantly, donors—that you attracted in 2008 are Democrats, and that, no matter what, they will continue to support Democrats. The problem is, they’re not….and they won’t.

Why? Because the vast majority of those new voters weren’t “redirected” from another Democratic candidate. Instead, they were “political non-participants” who had previously held no political affiliation whatsoever—and other than supporting you personally, the vast majority of those new voters have no long-term political affiliation now, other than, perhaps, “Progressive”.

The only reason they voted for you in the first place was because you were out promoting that whole “change you can believe in” thing. They saw you on TV telling people that universal access to care “…is a moral responsibility and a right for our country…”, and saying you would:

“…set up a government plan that would allow people who otherwise don’t have health insurance because of a preexisting condition, like my mother had, or at least what the insurance said was a preexisting condition, let them get health insurance”.

At that same evening’s event (the Democratic Presidential Debate of January 31, 2008), they also saw you say this:

“…because my view is that the reason people don’t have health care… [w]hat they’re struggling with is they can’t afford the health care. And so I emphasize reducing costs. My belief is that if we make it affordable, if we provide subsidies to those who can’t afford it, they will buy it.

Senator Clinton…believes that we have to force people who don’t have health insurance to buy it. Otherwise, there will be a lot of people who don’t get it.

…I think that it is important for us to recognize that if, in fact, you are going to mandate the purchase of insurance and it’s not affordable, then there’s going to have to be some enforcement mechanism that the government uses. And they may charge people who already don’t have health care fines, or have to take it out of their paychecks. And that, I don’t think, is helping those without health insurance.”

The fact that you said all those things brings us to problem number two: if you don’t live up to your…exceptionally public…campaign promises, you’re gonna get YouTubed.

Forget about the Republicans. The Netroots will dig these quotes up in about two seconds—in multi-part harmony, I suspect—and all of a sudden, all those “new voters” who helped put you over the top last time, instead of seeing change they can believe in, are going to start seeing you as the “same old same old”…and if that happens, they won’t be voting Democratic again (or for anyone else, for that matter) for years to come.

And if they won’t vote for you…they most assuredly won’t be giving money to Democratic causes and candidates…including you in 2012.

You have to understand, it’s a question of trust. We want to believe that you’ll do the right thing, but we have been lied to for eight years straight…and we now fundamentally mistrust our elected representatives…including you.

Not all the news here, however, is bad news.

There is a way to turn all this to your advantage, and it basically involves “leapfrogging” the opposition.

Here’s what you do:

In the speech tonight, you look America in the eye and you tell us that you said all along that we must have a public option if we hope to control costs, you tell us that insurers can’t continue to “exclude” us out of insurance, and that universal coverage is, indeed, a moral obligation for our Nation—and a smart investment to boot.

Tell America that you will fight for them and against the special interests that are trying to hustle us once again. Most importantly—and this will be The Tough Part—tell us that a bad bill is a bill you won’t sign.

You have to tell America that if we don’t get it this year, we’ll have to come back next year and try again. And if we have to, the year after that, and the next, and the next.

You also get to remind America exactly what kind of methods Republicans were wiling to use to advance their position over this past month, and whose interests they’re representing when they do it.

To put it another way, you gave ‘em enough rope, and now it’s time for some noose-tightenin’.

The best part: not only does this approach lay to waste Republican opposition, it reels in the wavering Democrats—and it allows them to go home and tell their constituents that “Barack Obama and I are fighting for people and businesses and jobs while Republicans fight for fat cat insurance companies”.

If it’s done correctly, the 2010 midterms will be y’all’s to lose—but as I said earlier, if you are seen as selling a political product everyone’s seen far too many times before, the cost could be brutal…maybe even “President Palin” brutal.

We all have a busy day today, especially you, Mr. President, so let’s wrap it all up:

You made a lot of campaign promises about public options and universal coverage and ending exclusion abuses, and now it’s come time to make good.

A lot of the people who supported you didn’t do it because you’re a Democrat—and not because they are, either. If you don’t make good, you got a problem, and so do the Democrats, possibly for years to come.

YouTube was a fantastic tool for you and the seed of trouble for many Republicans in ’06 and ’08—but if you’re not careful, the tables will turn, and a lot of the people doing the turning will be to your left.

Do it right and you and the Democrats have a superb opportunity to pivot on the opposition and imprint the Democratic “brand” for a new generation of voters—and donors—and an aggressive approach tonight could be the opening salvo of a message barrage that either forces Republicans to become more moderate, or turns them into a crazier political movement that loses seats and Governors in 2010 and carries even fewer states in the 2012 Presidential than they did in 2008.

Screw it up, and even Tina Fey might not be able to save us from the wrath of “Palin/Gingrich 2012”.